A ‘Miracle Molecule’ Could Cut Fentanyl Deaths in Half — Or Lead More Into Addiction

America’s sky-high rate of fatal fentanyl overdoses could be halved if users were treated with another opioid, Biden administration officials and a bipartisan group of senators believe.

They and others who support expanded access to methadone argue that allowing addiction specialists to prescribe it outside of the clinics (OTPs) now permitted to dispense it would save tens of thousands of lives.

But the proposal faces opposition from the health care providers with the most intimate knowledge of methadone treatment: methadone clinic directors. They tell POLITICO that allowing prescribing outside of clinics is risky without their strict safeguards.

Methadone is an addictive opioid that’s deadly if abused. “The idea that a physician in private practice without support staff … that they’re going to be able to treat a complex medical problem like the use of fentanyl, is just not substantiated,” said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence, which represents methadone clinics. The disagreement over how to proceed comes as fatal overdoses climbed more than 50 percent during the pandemic before declining slightly in the year ending in March to 103,451. And while proponents of making methadone easier to get say that toll is ample reason to rethink treatment rules that are now decades old, the clinics fear it’s a bad idea that could make the overdose problem worse. Thus far, they’re winning the debate in the only forum that matters: Congress.